Results: A total of 693 individuals with a self-reported diagnosis of RA during the study period were identified; 423 were aged 18-64 years and 270 were aged 65 years. Among patients aged 18-64, those with Medicaid or who were uninsured were less likely than those with private insurance to visit a rheumatologist (adjusted odds ratio [aOR] 0.13 and 0.17, respectively; p <.001) and to receive biologic DMARDS (aOR 0.09 [p <.001] and 0.16 [p <.01], respectively); those with Medicaid were also less likely to receive nonbiologic DMARDS (aOR 0.26 [p <.01]). Those with Medicaid were more likely than those with private insurance to be unable/delayed in getting prescription drugs (aOR 2.9 [p <.05]), to experience cognitive, social, and physical limitations (aOR 8.7 [p <.001], 4.7 [p <.001], and 2.5 [p <.05], respectively); they also reported significantly lower general health and health-related quality of life. Patients aged >= 65 experienced greater equity in care and outcomes.

Conclusions: Younger RA patients with Medicaid (including those who receive coverage under the Medicaid expansion component of the Affordable Care Act) may be at risk for inadequate treatment.